PL-12-2162Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 181574
Permit Number: PL -11 -12 -2162
Scheduled Inspection Date: November 21, 2012
Inspector: Hernandez, Rafael
Owner: MERA, RODRIGO & ADRIANA
Job Address: 225 NE 96 Street
Miami Shores, FL 33138 -2715
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Sprinkler System
Phone Number
Parcel Number 1132060134091
Building Department Comments
REPAIR BROKEN PIPE FOR SRPINKLERS
Infractio
Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
November 20, 2012
For Inspections please call: (305)762 -4949
Page 12 of 27
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
DING
PERMIT APPLICATION
FBC 20
romEva--,
GV 4 u
Permit Non T---S) (Da-
Master Permit No.
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder): Abiary, frkere, Phone#: (7'> -140 -q1-33
Address: r a'S CI (P4' kkt e
City:..!"Qi State: Tl— Zip:
131 3 f
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: 0c)-- C N 9( If-'l,t"an -,
City: Miami Shores County: Miami Dade Zip: 33 II 3 /
Folio/Parcel #:
Is the Building Historically Designated: Yes NO )( Flood Zone:
CONTRACTOR: Company Name: 1 OW&Q/( Phone #:
Address:
City: State: Zip:
Qualifier Name: Phone #:
State Certification or Registration #: Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ 80.0D Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration ❑New Atepair/Replacce ❑Demolition
Description of Work: L r 14-
***************************************p ************* ******* * *********** * * * * *** *****
Submittal Fee $ Permit Fee $ /O CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE
Milt
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for FT.ECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
0 er or Agent Contractor
The for oing ins s�, " was a jam • wled d) efore me j'• s ) ° The foregoing instrument was acknowledged before me this
•
day of , : ; �; ll Eby. �I 1 , . tJ' 1 i_ Je , day of , 20 _, by
ers >nall ova. o e or who has produced UM. ' who is personally known to me or who has produced
who is
NOTARY UBLIC:
litification and who did take an oath. as identification and who did take an oath.
Sign:
Print:
My Commission Expires:
APPROVED BY
U-15:1-7--- Plans Examiner
Structural Review
(Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09)
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Zoning
Clerk
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME:
PtdiQfla Hsfirot DATE: ti / 14l d �_
ADDRESS: D 5 KiE 9(1944-k Skeet
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to laws of the State of Florida, F.S 489.103(7).
And I have read and understood the following disclosure statement, which entitles me to work as my own contractor, I further
understand that I as the owner must appear in person to complete all applications.
State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The
exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must
supervise the construction yourself. You may build or improve a one - family or two - family residence. You may also build or improve a
commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and
occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the
construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption: You may not hire
an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state
law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your
supervision and must be employed by you, which means that you must deduct F.I.CA and with- holdings tax and provide workers'
compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances,
buildings codes and zoning regulations.
Please read and Initial each paragraph.
1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner - builder
permit under an exemption from the law. The exemption specifies that 1, as the owner of the property listed, may act as my own
contractor with certain restrictions even though 1 do not have a license.
Initial ay.
2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the
construction and is not hiring a licensed contractor to assume responsibility.
3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understand that 1 may protect myself
from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own
name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on
permits and contracts.
Initial
4. I understand that I may build or Improve a one family or two-family residence or a farm outbuilding. I may also build or improve
a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy.` It may
not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved
myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially
improved it for sale or lease, which violates the exemption.
Initial
5. I understand that, as the owner- buil,r, I must provide direct, onsite supervision of the construction.
Initial
6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or
residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or
municipal ordinance.
Initial_
7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that
erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner- builder, may be held
liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while
working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an
owner- builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
Initial
8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to
perform the work being done. Any person working on my building who is not licensed must work under my direct supervision
and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and
social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for
the employee. I understand that my failure to follow these may subject to serious financial risk.
9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable
laws and requirement that govern owner - builders as well as employers. I also understand that the
Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations.
Initial afiZt
10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the
United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the
Florida Construction Industry Licensing Board at 850.487.1395 or http: l/ www. mvforidalicense .comldbnrloro /cilbfindex.html
Initial
11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I am the party
legally and financially responsible for the proposed construction activity at the following address:
Initial __off`"
12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I
have provided on this disclosure.
Initial OH1�i-•-
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a
license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to
assist you with any financial loss that you sustain as a result of contractor may be in ciwl court. It is also important for you to
understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may
be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for
verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage.
Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and
retumed to the local permitting agency responsible for issuing the permit A copy of the property owner's driver license, the
notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when
the permit is issued.
Was acknowledged before me this I day of POi/ , 20
By WO,
who was personally known to me or who has
Produced there License orT\ t /� 1 0 "7 ~o ' ) t' fl as identification.
V CUBN iS at Florida
Public
• State ,,,,° "�+,�
Notary Sep 23, 2015
A _ My Comm Expires
_
Commission # EE 128810
''aofFs,^••
n,ni. ,. Banded 'Through National Notary Assn.
1
r.
HUD-1
A. Settlement Statement (HUD -1)
OMB Approval No. 2502 -0265
8. Type of Loan
$ 1. FHA Q 2. RHS
Q 4. V.A. Q 5. Cony. Ins.
Q 3. Corot Unfns.
0. File Number
Meta- 225MIand
ID:
7. Loan Number
8020137264
8. Mortg. Ina. Case Num.
005-2492832
C. NOTE This form le furnished to give you a statement of actual settlement costs. Amounts paid to end by the settlement agent are shown. Items
marked °(p.o.c.)' were pail outside the closing; they are shown here for Infor ed:1nel purposes and are not deluded In the totals.
D. NAME OF BORROWER:
Address of Borrower:
E. NAME OF SELLER:
Address of Seller
F. NAME OF LENDER:
Address of Lender.
G. PROPERTY LOCATION:
H. SETTLEMENT AGENT:
Address:
Place of Settlement:
L SETTLEMENT DATE
Rodrigo Mere and Addana Mere, his wife
225 NE 95 Street, MIanl Shores, Florida 33138
225 Miami Shores LLC, a Florida limited fi Wily company
5531 NW 112 Ave.., Suite 118, Dora!, Florida 33178
Navy Federal Credtl Union and/or Department of HUD
PO BOX 3328. Merrifield, Virginia 22119 -3328
225 NE 96 Street, Miami Shores, Florida 33138
IMAM SAAR81TORtA, ESQ., PA
21 SW 15th Road, Suite 200. Miami, Florida 33129
21 SW 15th Road, Suite 200, Miami, Ffodda 33129
9/21/12
DISBURSEMENT DATE 9/21/12
Phone: 305- 374 -4108
ummary n, •orrower's ?
Ih ici, to
100. Gross amount due from borrower.
101. Contract
400. Gross amount due to seller.
safes price
394,099.00
401. Contract sales price
394,000.00
102. Personal property
402. Personal property
103. Settlement charges to borrower (tine 1400)
21,104.37
403.
104.
404.
105.
405.
Adiustrnenls for items paid by seller in advance:
106. Criy/town tares
Adiustmerr`o for items paid by seller in advance:
408. CityRown texas
107. County taxes
407. County taxes
108. Assessments
408. Assessments
109.
409. '
119.
410.
111.
411.
112.
412.
120. Gross amount due from borrower.
200. Amounts void or in behalf of borrower_
201. Deposit or earnest money
415,104.37
5.000.03
420. Gross amount due to seller
500. Reductions in amount due to seller.
501. Excess deposit (see Iastnctfoa)
394,000.00
202. Principal amount al new loanfsl
350,000.00
502. Settlement charges to seller (One 1409)
39.704.00
203. Existing Ioan(s taken subject to
503. Existing lamb) taken settled to
204. Principal amount of second mortgage
.
504. Payoff of first mortgage loan
205.
505. Payoff al second mortgage loan
208.
506.
207.
507. Deposit Is being disburserd as proceeds
208. Principal amt of mortgage held by seller
508. Princpal amt of mortgage held b seller
209. Lender CC Credit
2.500.00
509.
209a.
Adjustments for items unpaid by seller_
210. City/town taxes
509a.
Adiustments for items unpaid by seller.
510. Cityltown taxes
211. County texas from 0101/12 to09 /21/12
2,871.61
511. County taxes from 01/01 /12to09 /21112
2,671.61
212 Assessments
512 Assessments
213.
513.
214. •
514.
215.
515.
216. •
516.
247.
517.
218.
518.
219.
519.
220. Total paid byffor borrower.
300. Cash at settlement fromito bon-ewer:
301. Gross amount due from borrower (fine 120)
360,371.61
415,104.37
520. Total reductions in amount due seller.
600. Cash at settlement to /from seller:
601. Gross amount due to seller tine 420)
42,575.61
394,000.00
302. Less amount paid by/for the borrower (fine 220)
(380.371.61)
602. Less total reductions inn amount due seller (One 520)
(42,575.61)
303. Cash ( g From ❑ To ) Borrower:
54,732.75
603. Cash (g To ❑ From ) Seller.
351,424.39
The Public Repotting Burden for this catleotion 01 Information Is estimated at 35 minutes per response for collecting, reviewing, and reportng the data. This agency
may not contact this information, and you are not required to complete this form, unless O displays a currently valid OMB control number. No confidentiality is assured;
gds disclosure le mandatory. This is designed to provide the parties to a RESPA covered transaction with Information during the statement process.
DoubteTImel3
2
L. Settlement charges
700. Total Real Estate Broker Fess 523,040.00 P
Pall from P
Page
Division of commission Oita 700) as idlows: B
Borrowers S
701. 9 11,820.00 to Le Playa Properties Group. Inc. S
et F
702. 511,820.00 to PRUDENTIAL FLORIDA REALTY
703. Commission paid at settlement 2
23,640.00
704.
705. Administrative fee to La Playa Pmp Group, Inc. 3
395.00
809, Items Pm,ab8, in Connection w�9r Loan --
801. Our orginat(on charge 33,50000 {Tram GFE #1)
802. Your credit or charge • •� nts) for the specific interest rate Leh 5875.00 {Prom GFE #2)
803. Your tad •�-e)neltoneh: !es . N. Federal Credit Union and/or D:..: (fromGFEA) 4
4.375.00
804, A • • reisat fee to Sc tdifl U.S. Inc. (from GFE #9) 465.0D POC (Br
805. Credit report to EQUIFAX (from GFE 63) 22.00 AOC (B)'
806. Tax service to (from GFE #3)
807. Flood Determtnetion fee to Flood Data Services Inc. 7
7.00
808. to
899. to
810. to
811. to
812. to
813, ro
900. Items Required by Lender to Be Paid in Advance _
901. Daily interest charges from 09121112 to 10/01/12 (off 31.0792 /day (from GFE #10) 3
310.78
202 M • : e insurance premium for months to N = Federal Credit Union and/or I (from GFE ant 5
5,125.00
903. Homeowners Insurance premium fr :, : to corn GFE #11)
904. First Year Hazard Insurance praniu 1 years to CITIZENS INS. CO. 2536.00 POC (B)'
905. years to
1000, Reserves Deposited with Lender
1001, Initial deposit f for your escrow account (from GFE #9) 3
3,981 Jffi
1002. Hom'eowner's insurance months GB der month
1003. Mortgage insurance monthslad per month
1004. P • -• :, taxes 12 months ;� 5331.75 .., month 33.981. 2
1005. Hazard instances 2 months ® 5211.50 par month 3423,00
1006. months A per moth
1007. months et per month
1008. months BS per month
1009. Aggregate accounting adjustment ($423.04)
1100. Tile Cham.,es _
1101, Title sernfaas and lender's title insurance (from GFE #4) 1
1,54200
1102. Setlement or closing fee to INAKI SAIZARBITORIA, ESQ. 81.160.00
1103. Owner's title insurance to Old Republic Nat Title4INAK( SAIZARBITORiA (from GFE #5) 2
2,04500
- -- -
- --
1104. Lender's title insurance to Old Republic Nat, TitledINAKI SAIZARBITORIA 3257.00
Mix;- 25.00:8.1- 25:F9- 207.00
) r,
1105, Lenders title pottcy ding $350.000.00
1106. Owners 3tle polcylimit 5394,000.00
1107. Agent's portion of the total tide insurance premium 31011.40 to INAKI SAIZARBITORIA. ESQ., P.A. "
1108. Underwriter's portion of the total Ode insurance
premium S690.80 to Old Republic National Title Insurance Camper
1109. Abstractor title search to Old Republic Nate Tide Ins' 2
250,00
1110. Courier fax, copies to INAKI SAIZARBITORIA. ESQ. 5126.00
1111. Attorneys fees to E9att Harris, P.A. 5
500.00
1112. Melee to INAKI SAIZARBITORIA, ESQ: 3
35
1113. to
200, Govemmenl Recordinn and Transfer Chances - -
-
1201. Government recorr3no charms (from GFE #7) 6
6350
1202. Dead 510.00 Monomers) Releases 30.00 510.00
1203. Transfer tares (from GFE #8) 1
1,925.00
1205. State tax /stamps Deed 52,364.00 Mortgage(s) 51,225.00 2
2,384.00
�• Termination Notice of Com. & TNeAffidavtl to Clerk of the Court 528.50
1207,
120 =, Reno .1, • and Process( ', to Humberto Hernandez 525.00
1300. Additional Settlement Chances -�
1301. Required services that you can shop for (farm GFE #O) 3
335.00
1302. Lien Search to Superior Lich Search, Inc. 1
165.00
1303. Su _ to John Ibarra &Assoc., Inc. 5335.00
1304, Escrow Water Holdback to INAic SAIZARBITORIA, ESQ., 2
250.00
1305. Renef Code Enforcement to Miami ShhoresdIttage -
-12500.00
1306. to
1307. to
1308, ro
1309.
1400. Trial Settlement Chaces
(Enter on lines 103, Section J and 502, Section K) 2
21,104,37 3
39,704.00
POC (B) '= Pahl otdsTde of dosing by borrower
° POC (S) = Pahl outside of dosing by seller
DoubleTime®
DeabteTlmee
SETTLEMENT CHARGES AND LOAN TERMS
Page 3
Settlement Charges
Charges ThatCennatinoroase
.. .... ... HUD-i Lb* Ntuv6er •:.. ; . ,.
00
... Fat�.,; fit'
e•'�`"k. "' K�c.
Our originatlon charge # 801
53,500.00
^
,iP'�"'
0
$3,500.00
Your credit or charge (points) for the sneers interest rate chosen # 802
5875.00
5875.00
Your situated origination charges # 803
54,375.00
54,375.00
Transfer taws # 1203
$3,589 .00t 51,925.00
Charges That In Total Cannot increase More-Man 10%
«n .
Government recording charges # 1201
570.00
583.50
Appraisal fee # 804
$965.00
$485.00
Credo repeat # 805
522.00
522.00
Flood Determination fee # 807
57.00
57.00
Mortgage Insurance premium for *MG
$8.125 .00
$8,125.00
Title seMces and lender's title Insurance # 1101
$2,745.00
51,542.00
Owner's title insurance it 1103
52,045.00
$2,045.00
Survey # 1303
5500.00
5335.00
Total
511,979.00
510,804.50
Increase between GFE and HUD-1 Charges
5- 1,374.50 or 0.00%
Charges That Can Change .
'.....94##.P.1114.1.0.1441..: 1- i:
`::' ` HUDi .; N :::.
Initial depesft for your escrow account #1001
$3,981.08
$3,981.08
Daily interest charges farm 6 901
_ 5341.87
$310.79
Homeowner's insurance premium for # 903
$.00
50.00
First Year Hazard insurance premium for # 904
52,538.00
52,538 .00
Loan Terms
Your initial loan amount ls
$ 350,00090
Yalu loan tem is •
30.0000 years
Your initial interest rate is
3.25 %
Your Iritlat monthly amount awed for printipai, interest,
and arty H
51,870.03 includes
Fjr Principal 5 Interest ;M Mortgage Insurance
Can your interest rate rise?
la No Q Yea , it can dee to a maximum of .001. The first change w9i be
on and can change again every err
. Every change date, your Interest rate can Increase or decrease
by .00%. Over the life of the loan, yea interest rate Is guaranteed to never be
lower than .004 or higher Man .00
E
balance ven It you payments on time, can your loan
la No Q Yes , k can rise to a maximum of $ .00
Even If you make payments on tine, can your monthly
amount owed for principal. Interest, and mortgage
insurance rise?
O No Q Yea , the first increase can be on rd the monthly amount
awed can rise to $ .00
The mariunum I can ever rise to is $ .00
Does your khan have a prepayment Penalty?
41 No 0 Yea . your muodm um prepayment penalty is 5 .00
Does your loan have a balloon payment?
It No 0 Yes , you have a btdtoon payment of $ .00 re in
years an 00/00/0000 .
Total monthly amount owed including escrow
payments
Q You do not have a monody escrow paymentlor [terns, such as property
taxes and homeowners insurance. You must pay these ltetce dlectly yourself.
• You have an additional monthly escrow payment of $ 543.26
that results le a total in03al ninthly amount owed of $ 2,413.29 its Includes
principal, Interest, any mortgage insurance and any items checked below:
1' PloPerlY baxes 17 HaneoamdsInsurance.
r Hazard insurance r
r r
Note: if you have any questions about the Settlement Charges and loan Tams listed on this form, Please contact yarn lerndt
DeabteTlmee
HUD -1 SETTLEMENT STATEMENT ADDENDUM
Flle Number. Mere- 225I1Ajam1
1 have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a
true and accurate statement of all receipts and disbursements made on my account or by me in this transaction.
1 further certify that I have received a copy of the HUD4 Settlement Statement.
225 Miami Shores LLC
a Florida tion
I.L,
ay: IMPIWALIQ
s
Manager &
(Corporate Seal)
Borrowers,
WIFAIJIh
a
Seller(s)
Cii1A i . as itkr N - I Vi Pi�s-CT
Settlement Agent
The HUD -1 Settlement Statement which I have prepared is a true and accurate account of this transaction. 1
have caused or will cause the funds to be disbursed in accordance with this statement.
Irtaxt SATZARBITORIA, ESQ., B.A.
By:
Date:
9/JJ7-
WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar
form. Penalties upon conviction can Include a fine and Imprisonment. For details see: Title 18 U.S. Code
Section 1001 and Section 1010.
DeublaTlmee